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Hip Problems, Age 12 and Older

Topic Overview

Hip pain can make it hard to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint ( snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms.

To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip problems

Hip problems may develop from overuse, bone changes with age, tumors, infection, changes in the blood supply, or a problem that was present from birth (congenital). Oddly enough, a person who has a hip problem often feels pain in the knee or thigh instead of the hip. The type of hip pain you have may help your doctor determine the cause of your pain.

Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.

Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.

Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip. Hip pain can have many causes.

Pain in the hip, thigh, or knee of an older child or teen may be caused by conditions such as slipped capital femoral epiphysis, in which the upper end of the thighbone (femur) slips at the growth plate (epiphysis), or Legg-Calve-Perthes disease.

Pain and stiffening in the hip may be caused by lack of blood flow to the hip joint (avascular necrosis). Pain in the knee may also be present.

Pain that shoots down the leg from the hip or lower back may be caused by an irritated or pinched nerve (sciatica).

Pain with weight-bearing that gradually worsens over several months may be caused by transient osteoporosis. This is more common in middle-aged men but also can affect women in the later part of pregnancy (third trimester). Osteoporosis related to pregnancy usually goes away on its own within 12 months of delivery.

Some types of bone cancer (osteosarcomas) and the spread of cancer to the bone (metastatic disease) can cause bone pain.

Treatment for a hip problem depends on the location, type, and severity of the problem, as well as your age, general health, and activities (such as work, sports, hobbies). Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.

Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Symptoms of infection may include:

Increased pain, swelling, warmth, or redness in or around the area.

Red streaks leading from the area.

Pus draining from the area.

A fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.

Long-term alcohol and drug problems.

Steroid medicines, which may be used to treat a variety of conditions.

Chemotherapy and radiation therapy for cancer.

Other medicines used to treat autoimmune disease.

Medicines taken after organ transplant.

Not having a spleen.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care in the next hour.

You do not need to call an ambulance unless:

You cannot travel safely either by driving yourself or by having someone else drive you.

You are in an area where heavy traffic or other problems may slow you down.

Keep bones strong

Exercise and stay active. It is best to do weight-bearing exercise, such as walking, jogging, stair climbing, dancing, or lifting weights, for 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 days a week. Talk to your doctor about an exercise program that is right for you. Begin slowly, especially if you have not been active. For more information, see the topic Fitness.

Don't drink more than 2 alcohol drinks a day if you are a man, or 1 alcohol drink a day if you are a woman. People who drink more than this may have a higher chance for developing osteoporosis. Alcohol use also increases your chance of falling and breaking a bone.

Stop or do not begin smoking. Smoking also increases your chance for developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Smoking.

Exercises to keep your hip and back area strong

Warm up and stretch before exercising to prevent problems.

Prone buttocks squeeze, to strengthen the buttocks muscles. These support your back and help you lift with your legs.

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